Measuring Mental Health Recovery: An Application of Rasch Modeling to the Consumer Recovery Measure.

As the need for recovery-oriented outcomes increases, it is critical to understand how numeric recovery scores are developed. In the current article, the modern Rasch modeling techniques were applied to establish numeric scores of consumers' perceptions of recovery. A sample of 1,973 adult consumers at a community-based mental health center (57.5% male; average age of 47 years old) completed the 15-item Consumer Recovery Measure. A confirmatory factor analysis revealed the unidimensional nature of the Consumer Recovery Measure and provided construct validity evidence. The Rasch analysis displayed that the items produced acceptable model fit, reliability, and identified the difficulty of the items. The conclusion emphasizes the value of Rasch modeling regarding the measurement of recovery and its relevance to consumer-derived assessments in the clinical decision-making process.

Measuring recovery related outcomes: a psychometric investigation of the recovery markers inventory.

The concept of recovery can be operationalized from either the point of view of the consumer or from the perspective of the provider of services. The Recovery Markers Inventory (RMI) was created to assess recovery-related factors (i.e., actions/events associated with consumer's recovery) from the provider's perspective. Evidence, which established the psychometric properties of the RMI, was obtained through the use of: (a) construct validity (i.e., confirmatory factor analysis and Rasch principal components analysis of residuals); (b) concurrent validity (i.e., the calculation of Pearson correlations between the RMI and other recovery-oriented instruments); and (c) reliability (i.e., Rasch Partial Credit models). Evidence presented in this article shows that the RMI scale is unidimensional, has an adequate level of correlation, and acceptable reliability. The current analysis provides evidence to support the RMI as a valid, reliable measure of recovery-related factors, which can complement consumer based instruments in the assessment of changes in recovery.

Seven key strategies that work together to create recovery based transformation.

This article describes seven key strategies used by the Mental Health Center of Denver in its quest to become a recovery-focused center. The description includes circumstances that were converted into opportunities for multi-level changes within the organization. The changes described include: (a) Vision and persistent leadership, (b) Consumer inclusion and involvement, (c) Seize opportunities to add recovery oriented ideas into clinical practice, (d) Providing the right level of service at the right time, (e) On site staff recovery training, (f) Hiring the right people, and (g) Outcome driven learning and quality improvement. We share our quest to show other centers that although system transformation takes work, it is something that centers across the nation can accomplish, and it makes our work much more meaningful.

Depressive symptoms in early marriage: predictions from relationship confidence and negative marital interaction.

The authors proposed a model of depressive symptoms in early marriage in which relationship confidence, defined as perceived couple-level efficacy to manage conflicts and maintain a healthy relationship, mediates the effect of negative marital interactions on depressive symptoms. The model was tested in a sample of 139 couples assessed prior to marriage and 1 year later. As predicted, relationship confidence demonstrated simple negative associations with negative marital interaction and depressive symptoms for all participants. Longitudinal path analyses supported the mediational model for women only. In women but not men, negative marital interaction indirectly had an impact on depressive symptoms through the mediator of relationship confidence. Findings suggest that relationship confidence may be important to understanding links between marital distress and depressive symptoms, especially in women.

Mechanisms of change in a cognitive behavioral couples prevention program: does being naughty or nice matter?

Although there is a body of evidence suggesting beneficial effects of premarital prevention, little research directly examines the mechanisms of effect. One study that examined changes in communication following training in the Prevention and Relationship Enhancement Program (PREP) found that, although couples made the expected communication gains pre to post PREP, female gains in positive communication were paradoxically associated with worse, not better, outcomes (Schilling et al., J. Fam. Psychol. 17(1):41-53, 2003). Using two samples, the current investigation did not yield evidence of such an association. We discuss issues related to replication studies (e.g., failure to reject null hypotheses), challenges in analyzing and interpreting dyadic data, and implications for prevention.

Timing is everything: Pre-engagement cohabitation and increased risk for poor marital outcomes.

Data from a longitudinal study were used to examine differences among couples that cohabited before engagement, after engagement, or not until marriage. Survey data and objectively coded couple interaction data were collected for 136 couples (272 individuals) after engagement (but before marriage) and 10 months into marriage. At both time points, the before-engagement cohabiters (59 couples) had more negative interactions, lower interpersonal commitment, lower relationship quality, and lower relationship confidence than those who did not cohabit until after engagement (28 couples) or marriage (49 couples), even after controlling for selection factors and duration of cohabitation. Our findings suggest that those who cohabit before engagement are at greater risk for poor marital outcomes than those who cohabit only after engagement or at marriage, which may have important implications for future research on cohabitation, clinical work, and social policy decisions.